Levin eases the path for veterans' health

As chief technology officer at the Veterans Affairs Department, Peter Levin leads efforts to modernize health records for veterans, create a joint record system with the Defense Department and tackle a backlog of claims related to Agent Orange exposure among Vietnam era veterans. He has made great strides in all those areas, but one initiative in particular has caught on beyond VA’s wildest expectations. Levin was chief architect and co-inventor of Blue Button, an online service that allows veterans to access and download the information from their My HealtheVet personal health records into a text file or PDF, which they can then share with health care providers, other caregivers or loved ones.

When I saw the report in the Washington Post in 2008 on how veterans were being mistreated at Walter Reed hospital, I called Gen. Wesley Clark. He has been a cherished mentor and friend.

I called Gen. Clark at home, and I was railing about it. And I said to him, "Aren’t you going to do anything about it?” And he let me go through my rant. And then he said, "Peter, what are you going to do about it?" That was the first step for me that led to joining the VA.

Being a CTO, I’m trying to do what we can in the public sector to use technology, IT, business analytics and data processing to improve health outcomes for 6 million people. The Blue Button started with an idea in the Markle Foundation’s Consumer Engagement Work Group. VA did the first implementation and the reference architecture. What makes the Blue Button unique is that it is easy to use and devastatingly effective. More than 700,000 people have used it, including 400,000 veterans.

I came into Blue Button absolutely cold. I was a computer engineer, working in the semi-conductor industry, with big and complicated datasets. But when you get used to thinking in that frame of reference, the Blue Button is not a big leap. At the Markle meeting, I was thinking, “Oh, yeah, we could do that.” It was a problem that needed a good solution. People had not realized how simple it could be.

Now the Blue Button has gone viral and is a de facto standard. It is being used for Medicare and Medicaid, and the Office of Personnel Management recently issued a letter so it would apply to all federal employees. It also is being used in the private sector by companies like Aetna, UnitedHealthcare and Microsoft.

Fast Track claims processing for veterans’ Agent Orange claims has been fabulous and successful, but I would not call it smooth. The problem is that there had been a natural isolation within VA. In claims processing, insurers know how to do it extremely well. By comparison, the VA was paper-bound, isolated and somewhat moribund in its business processes.

Fast Track is a fully electronic application that is Web-based. We set it up from beginning to end in 90 days. It is for a specific group of service-related disability claims. Thousands of vets have used it, and it has cut processing time about in half.

The [Veterans Health Information Systems and Technology Architecture] open-source ecosystem is another initiative that has exceeded our expectations. It is becoming a model of federal software production. It is not the typical government enterprise software process, which is long, arduous and often misses expectations.

The way technology evolves is so much faster now. For civilian systems, if you are using the old procurement style — with requirements, demonstration, testing and prototyping — you will inevitably fail. The open-source ecosystem is a new path.

The Census Bureau hasn't established a time frame for its cloud computing plans, including testing for scalability, security, and privacy protection, as well as determining a budget for cloud services.